Uncategorized

Assessing Long-Term Disability Claims After a Serious Accident in Ontario

18 Sep, 2025

Suffering a serious injury can change your life in an instant. While the road to physical recovery is often top of mind, navigating the legal and financial side, including securing post-accident disability benefits, is equally important. Many Ontarians are surprised by how complex long-term disability claims can be, especially when insurers challenge eligibility.

At MK Law, we help clients understand their rights and obligations under Ontario’s disability claim process. If your injury has impacted your ability to work, it’s crucial to act promptly and with clarity when pursuing compensation.

What Qualifies as a Long-Term Disability Claim?

In Ontario, long-term disability (LTD) claims are designed to provide income replacement when an individual is unable to work due to a medical condition. Most claims are initiated after short-term disability benefits are exhausted, often around the 17-week mark. LTD coverage may be available through employer insurance plans or private policies.

To qualify:

The injury must meet the definition of “total disability” under the policy.
A treating physician must provide evidence that you’re unable to work.
Claims must typically be submitted within a specific timeframe after the accident.

While the technical definition of total disability varies between insurers, it usually includes a substantial inability to perform your job, and eventually, any job, due to the injury or illness.

Common Issues in Serious Injury Disability Claims

Even when the injury is severe, insurers may deny or delay long-term disability claims in Ontario. Common challenges include:

Insufficient medical documentation
Disputes over the injury’s severity or impact
Conflicting assessments from independent medical evaluators
Missed claim deadlines
Surveillance or social media is used to contradict your claim

This is especially frustrating when dealing with the aftermath of a life-altering accident. MK Law supports clients by managing deadlines, coordinating medical evidence, and representing them if a claim is denied or terminated.

How Disability Benefits Interact with Personal Injury Settlements

If your accident was caused by another party, such as in a motor vehicle collision, you may pursue both a personal injury claim and long-term disability benefits. However, these compensation streams can affect each other.

For example:

LTD insurers may deduct personal injury settlement amounts from future payouts.
Your claim for pain and suffering does not reduce your disability benefits, but amounts allocated for income replacement might.
Structured settlements must be carefully planned to avoid impacting benefit eligibility.

Our role is to ensure that any settlement or award reflects the full extent of your losses, without jeopardizing access to post-accident disability benefits.

When Should You Contact a Lawyer?

Many people wait until a denial to seek legal help, but consulting a lawyer early in the process can improve your chances of approval and avoid costly mistakes. At MK Law, we guide clients through the following:

Understanding eligibility requirements
Gathering the right medical and occupational evidence
Communicating with insurers
Filing timely appeals if needed

Whether you are facing a claim denial or want to ensure a strong initial application, our team can help you move forward confidently with your serious injury disability claim.

Navigating Disability Claims After an Accident, With Support That Matters

Navigating long-term disability claims in Ontario is never easy, especially when you’re also coping with physical, emotional, and financial challenges. At MK Law, we aim to lift the burden by providing strategic legal support and clarity every step of the way. Whether you’re just beginning your claim or facing a difficult insurer decision, our approach is grounded in advocacy and compassion. We’re here to help protect your rights and your recovery.